


							<form id="myform2" name="myform2" method="post" action="insert.php">
	
							
										<fieldset><label for="firstname">First 
										Name </label>
										<input id="firstname" name="firstname">
										<br>
										<label for="lastname">Last Name</label>
										<input id="lastname" name="lastname">
										<br>
										<label for="addr1">Address</label>
										<input id="addr1" name="addr1"> <br>
										<label for="addr2">Address Line 2</label>
										<input id="addr2" name="addr2"> <br>
										<label for="city">City </label>
										<input id="city" name="city"> <br>
										<label for="state">State </label>
										<input id="state" name="state"> <br>
										<label for="zip">Post Code</label>
										<input id="zip" name="zip"> <br>
										<label for="tel">Telephone #</label>
										<input id="tel" name="tel"> <br>
										<label for="email">Email </label>
										<input id="email" name="email"> <br>
										<label for="request">Request </label>
										<input id="request" name="request"> <br>
</fieldset>
		

					<font color="#FF0000">Net Total: $<span id="net">110.00</span></font>
									

									

								
										<fieldset><label for="cardtype">Credit 
										Card</label>
										<select id="CardType" size="1" name="cardtype">
										<option value="Visa" selected>Visa
										</option>
										<option value="MasterCard">MasterCard
										</option>
										</select> <br>
										<label for="cardnumber">Card Number
										</label>
										<input id="CardNumber" name="cardnumber">
										<br>
										<label for="nameoncard">Name on Card
										</label>
										<input id="nameoncard" name="nameoncard">
										<br>
										<label>Expiry</label>
										<span class="month_label">MM</span>
										<span class="month_input">
										<input id="expiry_month" name="expiry_month"></span>
										<span class="year_label">YY</span>
										<span class="year_input">
										<input id="expiry_year" name="expiry_year"></span>
										<br>
										<label for="cvv2">CV Code </label>
										<input id="cvv2" name="cvv2"> <br>
</fieldset> 


							</form>
							<p><font size="4">Here is my basic form, I would 
							like this from to be submitted in the background 
							using <font color="#000080">CURL / AJAX</font> to 
							virtual merchant. The response from Virtual merchant 
							should come back as JavaScript alert. If the the 
							response is good it should submit the form (insert.php)</font></p>
							<p><font size="4">please see how to integrate here:</font></p>
							<p>
							<a href="https://www.myvirtualmerchant.com/VirtualMerchant/download/developerGuide.pdf">
							<font size="4">Download Developer Guide</font></a></p>
							<p><font size="4">
							<a href="https://www.myvirtualmerchant.com/VirtualMerchant/download/developerGuide.pdf">
							https://www.myvirtualmerchant.com/VirtualMerchant/download/developerGuide.pdf</a></font></p>
							<p>&nbsp;</p>
							<p>&nbsp;</p>
